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Journalism of Courage
The room is pitch dark, there’s pin-drop silence, and aromatic incense candles have created the perfect atmosphere to hit the bed and get engulfed in a deep, restful sleep. However, for some reason, despite such a perfect setting, sleep continues to evade many people. This is because planning too much can also induce sleep performance anxiety, experts say. “In this, the individual thinks, ‘I am doing so much… now I have to fall asleep. What if I don’t?’ Once the anxiety to sleep comes into the picture, the chances of sleep become even lesser, and the cycle begins — more the effort to fall asleep, less the likelihood of actually sleeping,” explained Dr Sachin Baliga, Consultant, Psychiatry, Fortis Hospital, Bannerghatta Road, Bengaluru.
In such a case, what can one do? The opposite! “Paradoxical intention is a psychological technique that involves doing the opposite of what one would normally do to achieve a specific result. In short, you set out to do exactly what you’re avoiding, thus, breaking the anxiety and fear cycle. As such, you reduce the performance anxiety related to sleep,” the expert explained.
Agreeing, Dr Ravindra Shrivastava, Director- Neuroscience, Primus Super Speciality Hospital added that this technique is often used to treat anxiety disorders or phobias. “Paradoxical intention is typically practised by having the individual intentionally engage in the feared behaviour, or imagine engaging in the behaviour, while simultaneously reframing their thoughts about it positively or humorously. This can help to reduce the anxiety or tension associated with the behaviour,” he said.
But, how to practise this? By intentionally trying to stay awake! Through this technique, the individual may paradoxically become more relaxed and eventually fall asleep more easily as it reduces the anxiety and tension that can contribute to insomnia. “It can aid in sleep in those suffering from chronic insomnia by removing the pressure to ‘perform’ (in other words, to fall asleep). Once the pressure is gone, you are more likely to be calmer, more relaxed, and more likely to fall asleep naturally,” Dr Baliga said.
Breaking it down for us, the expert explained that all you need to do is intentionally stay awake for a short period when you go to sleep the next time. “Ask yourself, ‘what does a sound sleeper do to fall asleep?’ The answer is ‘nothing’. When you go to bed the next time, go as you would normally do, but do not close your eyes. The intent is to stay awake without forcing yourself to. That means not engaging in stimulating activities like using mobile phones or watching OTT. Just continue to lie in bed and remind yourself of the intention we just discussed: ‘I am feeling drowsy, but let me stay awake for a couple of more minutes’.”
Adding, Dr Pallavi Joshi, Consultant Psychiatrist, Manipal Hospital, Varthur, Bangalore said that in this technique, experts instruct the patient to decide that he wishes to stay awake as long as possible. “So, the idea is to turn the story around using a paradox, as the patient now wishes for what he previously feared, and as time passes this performance anxiety goes down with facing it rather avoiding it,” she said.
But like all techniques, you must follow certain dos and don’ts.
Dos
*Use paradoxical intention under the guidance of a trained therapist
*Maintain a positive or humorous attitude
*Start with short periods of practice
*Be patient with the process
*Do try the technique along with other good sleep hygiene techniques
Don’ts
*Don’t use paradoxical intention without professional guidance
*Don’t use it for severe or life-threatening conditions
*Don’t become overly anxious or tense about the process
*Don’t use in severely depressed patients or patients with blood pressure or cardiac instability or uncontrolled diabetes
(Next in the series: Do you ever struggle to move or speak while sleeping or upon waking? Here’s why)
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